Abstract
We reviewed the diagnostic efficacy for detection of prostate cancer. Digital rectal examination (DRE), prostate-specific antigen (PSA), transrectal ultrasound (TRUS) and prostatic biopsy are useful tools for the diagnosis of prostate cancer.
PSA specificity for detection of prostate cancer is low and it alone is not a perfect screening tool, though it is widely used as a tumor marker for diagnosis and monitoring of prostate cancer.
To show the importance of PSA specificity, four methods are discussed: age specific PSA, PSAdensity (PSAD), PSAvelocity (PSAV), and PSA forms. PSAV and PSA forms may be the most useful in the selection of patients for prostate biopsy. Although ultrasound-guided systematic biopsy is useful for diagnosis of prostate cancer, controversy exists regarding biopsy using TRUE in the presence of a palpable abnormality on DRE.
The interpretation of a biopsy provides important staging information and can predict results of radical prostatectomy.
This article also reviews the value of imaging studies in the clinical staging. Though the role of imaging studies is currently limited, endorectal coil magnetic resonance imaging (MRI) may be assessed in combination with other data, such as PSA.
